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Recuperation of severe tumoral calcinosis in a dialysis patient: A case report

查看全文 作  者:Lukas [1]Westermann;Lisa K [2]Isbell;Marie K [3]Breitenfeldt;Frederic [1]Arnold;Elvira [1]Rothele;Johanna [1]Schneider;Eugen [1]Widmeier 高影响力作者 机构地区:[1]Department of Medicine IV,Medical Center,University of Freiburg,Faculty of Medicine,University of Freiburg,Freiburg 79106,Germany;[2]Department of Medicine I,Medical Center,University of Freiburg,Faculty of Medicine,University of Freiburg,Freiburg 79106,Germany;[3]Dialysis Center Freiburg,Freiburg 79100,Germany高影响力机构 出  处:《World Journal of Clinical Cases》索引2019年第7卷第23期,共7页高影响力期刊 摘  要:BACKGROUND One of the common late sequela in patients with end-stage renal disease(ESRD)is the calcium phosphate disorder leading to chronic hypercalcemia and hyperphosphatemia causing the precipitation of calcium salt in soft tissues.Tumoral calcinosis is an extremely rare clinical manifestation of cyst-like soft tissue deposits in different periarticular regions in patients with ESRD and is characterized by extensive calcium salt containing space-consuming painful lesions.The treatment of ESRD patients with tumoral calcinosis manifestation involves an increase in or switching of renal replacement therapy regimes and the adjustment of oral medication with the goal of improved hypercalcemia and hyperphosphatemia.CASE SUMMARY We describe a 40-year-old woman with ESRD secondary to IgA-nephritis and severe bilateral manifestation of tumoral calcinosis associated with hypercalcemia,hyperphosphatemia and tertiary hyperparathyroidism.The patient was on continuous ambulatory peritoneal dialysis and treatment with vitamin D analogues.After switching her to a daily hemodialysis schedule and adjusting the medical treatment,the patient experienced a significant dissolution of her soft tissue calcifications within a couple of weeks.Complete remission was achieved 11 mo after the initial diagnosis.CONCLUSION Reduced patient compliance and subsequent insufficiency of dialysis regime quality contribute to the aggravation of calcium phosphate disorder in a patient with ESRD leading to the manifestation of tumoral calcinosis.However,the improvement of the treatment strategy and reinforcement of patient compliance enabled complete remission of this rare disease entity. 关 键 词:End-stage RENAL disease RENAL replacement therapy-dialysis HYPERPARATHYROIDISM HYPERCALCEMIA HYPERPHOSPHATEMIA Tumoral CALCINOSIS Case report
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